Comparison of regional approach to deinstitutionalisation in Czechia
Milena Johnová, deinstitutionalisation expert working for Inclusion Europe, writes:
On 9 September, I shared my experiences with deinstitutionalisation in Czechia with members of the Community of Practice on Social Inclusion, at an event organised by the Social Innovation Initiative+ in Prague.
I presented a comparison of how Czech regions approach efforts to transform institutions into community-based social services. It's based on four criteria:
- Deinstitutionalisation is part of the regional strategy
- At least one institution was closed
- The strategy of deinstitutionalisation is stable
- Full deinstitutionalisation commitment exists
The darkest-coloured areas on the map show two regions meeting all four criteria.
The differences between regions are huge: While some regions are closing their last remaining institutions, others prepare to build new ones. National commitment and coordination remains a significant gap.
In more detail:
1. Deinstitutionalisation is part of regional strategy
Deinstitutionalisation is approved in a strategic document, such as the region's plan for development of social services, or a strategy for deinstitutionalisation (transformation of institutional care).
2. At least one institution was closed
Institutional building has been closed and is no longer used to house people with disabilities.
3. A commitment to full deinstitutionalisation
The region has committed to ending institutional care.
4. Deinstitutionalisation is a stable strategy
The transformation effort survives changes in the political leadership of the region.
How the regions perform
Two regions are at the top of the transformation efforts: Pardubice region, and Moravian-Silesian region.
- Transformation of institutional care is a permanent policy.
- The regions have been systematically transforming institutional care into community-based social services (for almost twenty years in the case of the Moravian-Silesian Region).
- Of course, it would be possible to proceed more consistently in the spirit of Article 19 of the Convention on the Rights of Persons with Disabilities. If the regions continue, they will probably end up in a similar situation to that of Spain, which is currently dealing with a second wave of deinstitutionalisation based on the transformation of services in group homes into fully personalised support.
- In any case, these two regions are admirable in the context of other Czech regions; only these two regions have a clear vision of ending institutional care.
Regions where deinstitutionalisation has a firm place in the regional strategic documents: Karlovy Vary, Liberec, Hradec Králové, and Vysočina.
- The replacement of institutional facilities by community-based services does not provoke political opposition, and deinstitutionalisation survives changes in the regional leadership.
- Yet, the vision of ending institutional care is lacking in these regions.
Perpetual beginners: City of Prague, and South Moravian Region.
- The problem of institutional care is reflected in strategic document, but not much has been done about it.
- Prague especially has history of relocating residents with disabilities outside of the city to other regions, including to places far away at borders to Germany. Even the best community services outside the city are not consistent with the right of Prague residents to live in their community. Interestingly, Prague first transformed its institution in the mid-1990s thanks to the exceptional director of the institution in H. Poustevna, Milan Cháb.
Laggards: Central Bohemia, Southern Bohemia, Pilsen, Olomouc, and Ústí nad Labem regions.
- In these regions, the closure of institutions usually occurred when investment money from EU funds came together with the personal commitment of the director of some regional organisation, or the transformation is mentioned in the regional medium-term plan of social services development.
The Ministry of Labour and Social Affairs of the Czech Republic itself establishes five institutions, and has no transformation strategy of its own.
Country
| Score
| DI is included in the strategy | Min. 1 institute has been closed | Vision of ending institutional care | Stable DI policy |
Moravian-Silesian | 4 | 1 | 1 | 1 | 1 |
Pardubice | 4 | 1 | 1 | 1 | 1 |
Carlsbad | 3 | 1 | 1 | 0 | 1 |
Zlín | 3 | 1 | 1 | 0 | 1 |
Highlands | 3 | 1 | 1 | 0 | 1 |
Liberec | 3 | 1 | 1 | 0 | 1 |
Hradec Kralove | 3 | 1 | 1 | 0 | 1 |
South Moravian | 2 | 1 | 0 | 0 | 1 |
Hl. m. Prague | 2 | 1 | 1 | 0 | 0 |
Central Bohemia | 1 | 0 | 1 | 0 | 0 |
South Bohemia | 1 | 0 | 1 | 0 | 0 |
Pilsen | 1 | 0 | 1 | 0 | 0 |
Olomouc | 1 | 1 | 0 | 0 | 0 |
Ústí | 1 | 1 | 0 | 0 | 0 |
The score was developed using documents publicly available in September 2023, and author's knowledge of deinstitutionalisation process in Czechia.
